Time to think about supplying heroin on NHS, says drugs tsar

THE Capital's drugs tsar, Tom Wood, has urged the Scottish Executive to consider prescribing heroin to addicts on the NHS.

Mr Wood, chairman of the Edinburgh Drugs and Alcohol Action Team, said providing a controlled supply of the class A drug to certain addicts may prove more helpful than giving them methadone.

The former deputy chief constable of Lothian and Borders Police said methadone was being too widely used in Edinburgh and radical alternatives needed to be considered.

He stressed he was not advocating the prescription of heroin, simply suggesting the idea should be explored, alongside other alternative treatments.

The idea received a cautious welcome from drug abuse support groups, although one pressure group condemned the possibility as "legalising drug-dealing".

More than 3000 people a year are being prescribed methadone in Lothian and the number is rising faster than elsewhere in Scotland.

The number of addicts being prescribed the heroin substitute - which has been condemned as a treatment because it is more addictive than heroin - rose by 42 per cent in the Lothians between 2002 and 2004, from 2191 to 3104. That compared to a 17 per cent rise across Scotland as a whole.

The estimated cost of prescribing methadone in the Lothians is almost £2 million, with an £11.6m bill for the entire country.

Mr Wood's interest in the possibility of prescribing heroin was spurred by events in Switzerland, where the first large-scale investigation into its benefits is taking place. Initial results suggest it can benefit addicts who had been continuing to use heroin after being prescribed methadone. The Swiss findings suggest prescribing heroin to this hard-core group of users can speed their recovery and cut the amount of crime committed by 60 per cent.

Mr Wood said: "We should look at each case on its merits. In Switzerland they have used heroin itself in a controlled environment. I'm not saying I support that, but it is an option we should look at.

"I'm not a medic and I can't give a medical opinion, but [prescribing heroin] may be the best thing for some people. It seems to have worked in other parts of the world. Methadone has been hugely successful, unfortunately we've become overdependent on it. It is only meant to be the first rung on the ladder. The problem is in many cases there are no other rungs."

Mr Wood said he still thought encouraging addicts to go "cold turkey" was the best option, but prescribing heroin and other alternative approaches - including newer drugs such as buprenorphine and dihydrocodeine - should be considered.

John Arthur, of Crew 2000 drugs support service, said: "Tom's idea is certainly interesting and one that I think we have to examine. However, if you're starting from the point that all drug prescribing to addicts and dependant users is a means to get them off drugs then you're on a hiding to nothing.

"Not everyone can or will come off drugs no matter what we do.

"If, however you want to prescribe drugs to reduce the harm from using street drugs, to help people stabilise their lives, and cause less acquisitive crime, then prescribing heroin should be one tool in the armoury of the state."

A spokesman for charity Turning Point Scotland added: "We would welcome any discussion about the various types of treatment. We would be in favour of any treatment that would assist addicts to move on with their lives."

Gaille McCann, founder member of the pressure group Mothers Against Drugs, agreed methadone use is out of control, but said the problem should be seen as a warning against prescribing heroin. She said:

"If we are now talking about prescribing heroin because we've lost control of methadone - that's absolutely stupid. If heroin is prescribed on the NHS when are people going to want to come off it? We are going to legalise drug-dealing in this country."

An Executive spokesman said: "We've got no plans to introduce heroin prescriptions. However, pilot schemes are running south of the Border and we will keep an eye on them and those abroad."

MSPs call for an end to methadone at home

MSPs today demanded changes to the law which allowed tragic toddler Derek Doran's parents to have methadone in the house.

Christine Grahame, MSP for South of Scotland, which takes in East Lothian, called for methadone to be taken only under medical supervision.

And Scottish Conservative leader Annabel Goldie asked for the whole issue of methadone to be reviewed.

The criticisms come after the death in Elphinstone, East Lothian, of two-year-old Derek Doran, who drank his parents' methadone.

The toddler died on December 13 after apparently mistaking the heroin-substitute for a soft drink.

Ms Grahame said: "Why was there a supply of methadone in the house in the first place?

"Is it appropriate in all cases that methadone is given in the home? This should be looked at again. I have huge concerns over children being able to access it."

Miss Goldie said: "This tragedy has highlighted what is a completely unacceptable situation. As it currently stands, methadone is part of the problem, we are heading for one million scripts issued per year."

An investigation is under way into the toddler's death.

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Heroin prescribing here in the UK should definetely be expanded,at the moment its used as a last ditch treatment option for chronic long-term IV users who've gone through all the treatments available but still lead chaotic lives with added complications of HIV/hepatitis etc. as well as law related issues,i.e. in and out of jails for various reasons,but i feel it should be expanded as an option to the homeless street addicts as a way of getting them into some form of treatment and on the road to getting back on their feet,in london they say a large % of the homeless have drug and alcohol problems,and its this that is one of the main barriers to getting out of that life,after all,if your having to find ways of getting cash to score,all day,every day,then things like getting on housing lists are going to be a low priority,not just the homeless,but addicted sex workers should be offered heroin scrippts too,a perfect example of how this could have helped,was the spate of murders of prostitutes in the ipswich area,they said to them,'dont go out on the streets cause theres a nutcase on the loose',but cause many of the girls were addicts they had to take the risk,and of course more ended up being murdered,even if the scripts were used temporarily to keep them away from the streets,some wouldnt have been murdered,but dumb politics gets in the way of saving lives with the war on drugs,which was lost before it began.

I second CZ-ONE's opinion in respect of Diamorphine scripts which should be expanded. Also the current situation with Diconal (de facto banned, a few 50-somethings in London getting it on a Home office licensed private script) ought to be changed. Diconal, despite its abuse risks with injection, is an effective analgesic and should be offered to anyone in severe pain as an alternative to morphine/OxyContin and especially in cancer pain where the fast onset, very high potency and added antiemetic make it almost the perfect choice. It could also be consumed under supervised consumption for polydrug abusers in treatment, as an alternative to Physeptone and removing the stigma of being on methadone and often having to sip green linctus in front of everyone (despite the guidance that a private room should be available for this purpose).